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1. What is your age?
Under 30
30–39
40–49
50–59
60+
2. What is your relationship/family status?
Single
Married
Divorced / Separated
In a committed partnership
I have children
I do not have children
3. Are you a business owner?
Yes
No
What industry are you in?
4. What is your top priority or challenge right now in life or business?
5. Have you ever worked with a coach, therapist, or joined a men’s group or retreat?
Yes
No
6. How would you describe your spiritual life right now?
Strong and central to my life
Open and evolving
Curious but unsure
Not part of my life
7. Do you feel grounded in your identity and aligned with your life path?
Yes
Somewhat
No
8. What areas of your life are most in need of clarity, breakthrough, or transformation right now? (Choose up to 3)
Business / Career
Health / Energy
Marriage / Partnership
Fatherhood / Family
Spirituality / Faith
Emotional Healing
Leadership / Purpose
Money / Financial Alignment
Identity / Direction
9. Are you currently experiencing any of the following challenges? (Choose up to 3)
Chronic fatigue or burnout
Anxiety or stress affecting performance
Feeling stuck or unclear in my purpose
Disconnection in my marriage or family life
Physical symptoms without clear answers
None of the above
10. Have you ever experienced a spiritual awakening, ceremony, or breakthrough that shifted how you see life?
Yes
No
I’m not sure
11. What’s more true for you right now?
I know I’m meant for more — I just need clarity and support
I’m overwhelmed and don’t know where to begin
I’m doing well, but I want deeper alignment
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